Individual
JOHN JOSEPH OLESNAVAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
3926 SQUAW BEACH ROAD, BIG BAY, MI 49808-0254
(906) 250-4799
Mailing address
3926 SQUAW BEACH ROAD, P O BOX 254, BIG BAY, MI 49808-0254
(906) 250-4799
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6301010173
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
237649000
MAGELLAN HEALTH
MI
01
—
680E210290
BCBSM PIN NUMBER
MI
Enumeration date
06/27/2006
Last updated
07/07/2009
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